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San Diego Long Term Care Integration Project

San Diego Long Term Care Integration Project. Presentation to: LTCIP Planning Committee April 12, 2006. Agenda items. Three-Strategy Overview and Update Discussion of Recommendations to Board of Supervisors Physician Strategy Implementation Plan. Mrs. C. 84 year old woman lives alone

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San Diego Long Term Care Integration Project

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  1. San Diego Long Term Care Integration Project Presentation to: LTCIP Planning Committee April 12, 2006

  2. Agenda items • Three-Strategy Overview and Update • Discussion of Recommendations to Board of Supervisors • Physician Strategy Implementation Plan

  3. Mrs. C • 84 year old woman lives alone • CHF, HTN, diabetes, hearing and vision loss, IADL dependencies • 16 medications by 6 physicians • Medicare and Medi-Cal beneficiary • Only child lives in Chicago

  4. Ideal System In-HomeServices PrimaryCare AcuteHospital MealsService MRS. C. DayHealthCare Transit Medical Specialty SkilledNursingFacility Mrs. C & Care Manager Journal of the American Geriatrics Society, Feb. 1997

  5. San Diego Stakeholder LTCIP Vision for Elderly & Disabled • Develop “system” that: • provides continuum of health, social and support services that “wrap around consumer” w/prevention & early intervention focus • pools associated (categorical) funding • is consumer driven and responsive • expands access to/options for care

  6. Stakeholder Vision (continued) • Fairly compensates all providers w/rate structure developed locally • Engages MD as pivotal team member • Decreases fragmentation/duplication w/single point of entry, single plan of care • Improves quality & is budget neutral • Implements Olmstead Decision locally • Maximizes federal and state funding

  7. NOC Update • AoA & CMS funds of $610,000 (3 yrs) • For “Aging & Disability Resource Center • Goals: provide improved access to LTC, communication across continuum, build on existing resources • Activity: surveys, Call Centers, CBOs input leads to improvements • Next: test fixes then media/PR/outreach to underserved communities

  8. BOS Recommendation for NOC/ADRC • Accept the Annual Report on the Network of Care/ADRC Strategy

  9. Healthy San Diego Plus Update • Personal Care Services Workgroup • Governor’s proposal • Stakeholder support • Decision re: Governor’s proposal

  10. Governor’s Proposal Highlights • GMC counties: HSD+ for Medi-Medi’s • Voluntary enrollment, 5 year pilot • IHSS not included • Dual capitation from Medicare and Medi-Cal to support preference, home and community-based care (including PCS) to avoid high-cost utilization (hospital, ER, SNF)

  11. BOS Recommendations for HSD+ • Approve the development of a voluntary pilot called Healthy San Diego Plus (HSD+) for acute and long term care integration, based on the Governor’s “Access Plus” proposal, with authority for the HHSA Director to implement any necessary program changes. • Direct staff to seek the appropriate venue for necessary legislative changes for HSD+. • Approve grant applications and receipt of grant funds from the State Department of Health Services and the California Health Care Foundation; to complete readiness activities for HSD+.

  12. Physician Strategy—Planning Phase • Fee-for-service initiative to improve chronic care management • Partner w/physicians vested in chronic care • Develop interest/incentive for support of HCBC • Implementation Plan for continued funding • Train on healthy aging, geriatric/chronic disease protocol, pharmacy, HCBC supports • Funding: $142,000 (planning) CA Endowment

  13. Physician Strategy Update • 50 physicians engaged in initiative at varying levels • Compiled list of barriers to improved chronic care • LTCIP CBOs engaged in problem-solving discussions with docs • Draft Implementation Plan developed for additional 3 years of funding

  14. BOS Recommendation for Physician Strategy • Accept the Physician Strategy Final Planning Phase Report and proposed Implementation Plan

  15. Implementation Plan Proposal (FY 06-09) • Community Care Training/Team-Building • Chronic Care Management • Understanding aged and disabled populations and needs • Collaboration techniques across health and social service providers • Finding resources for community-based services, patient education material, communication with other providers, etc.

  16. Next Steps • 50 physicians have been invited to review and provide input • Invite out to expand physician participation to more caring for underserved/minorities • Revise Plan with input of docs • Grant application to CA Endowment • May PC meeting: Medicare FFS pilots

  17. For more information: • Log onto website for background & info: www.sdcounty.ca.gov/cnty/cntydepts/health/ais/ltc/ • Call or e-mail: evalyn.greb@sdcounty.ca.gov, 858-495-5428 or sara.barnett@sdcounty.ca.gov, 858-694-3252

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